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Hello sir, if you are talking about England, a colleague from England could answer your question. If you are talking about the United States I am not sure what you mean by national health service. We currently do not have NHS in the US. From your photograph you definitely are a candidate for orthodontic surgery to correct the functional aspects of your occlusion.
Your impression is correct. But the problem is due to the orthodontics tilting the lower teeth too far forward thereby reducing the 'overjet' and limiting the amount the lower jaw can move forward. Do not have the upper jaw advancement with your nose/lip angle or it will not look positive!....
I have performed over 4000 of your type of necessary procedures, (orthognathic surgery).I would have to see you in person but I would probably recommend maxillary advancement with mild mandibular setback The need for genioplasty after those procedures would have to be assessed at that time and...
The downgrading of your maxilla will of course lengthen your face exactly by the number of mm downgrafted. It is simple math. Likewise a lenghrhenig Genioplasty will do the same and will lengthen the lower 1/3 of your face from the lip commissure downward and it will stretch your skin as you asked.
